• Title/Summary/Keyword: Carcinoma in Situ

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The Value of I-Scan Image-Enhanced Endoscopy in the Diagnosis of Vocal Cord Leukoplakia

  • Lee, Young Chan;Eun, Young-Gyu;Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.98-102
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    • 2018
  • Background and Objectives : Detection of vascular abnormalities in vocal cord (VC) leukoplakia is important for the diagnosis of neoplastic change of the mucosa. The aim of this study was to investigate the value of i-scan in the differential diagnosis of VC leukoplakia based on visualization of abnormal vascular features. Material and Methods : Fifty-two patients with leukoplakia were enrolled in the study. Images of their larynx obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results : Among the 52 leukoplakia patients, 7 (13.5%) patients had squamous hyperplasia, 10 (19.3%) mild dysplasia, 2 (3.8%) moderate dysplasia, 14 (26.9%) severe dysplasia, 4 (7.7%) carcinoma in situ, and 15 (28.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, abnormal vascular change with neoplastic neoangiogenesis was detected in most cases of malignant VC lesion [severe dysplasia : 9/14 (64.3%), carcinoma in situ: 2/4 (50.0%), and invasive squamous cell carcinoma : 11/15 (73.4%)]. Conclusion : i-scan-enhanced endoscopy is a useful optical technique for the diagnosis of VC leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of laryngeal cancer.

Comparing the Change in SUVmax Over Time by the Type of Ductal Breast Carcinoma (유방암 환자 중 유관에서 발병되는 암의 종류(IDC와 DCIS)별 시간경과에 따른 SUVmax 변화에 대한 비교)

  • Hyoung, Mi-Jin;Kim, Jeong Nip;Moon, Pyeong Soo;Kim, Kil Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.140-144
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    • 2014
  • Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

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Immunocytochemical Assay of Cathepsin D in Fine Needle Aspiration Cytology of Breast Carcinoma and Benign Breast Diseases (유방암종과 양성 유방 질환의 세침흡인 검체와 조직에서의 카뎁신 D 단백질의 발현)

  • Park, Kyeong-Mee;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.11 no.2
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    • pp.75-81
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    • 2000
  • Cathepsin D is a protease which is known to facilitate invasion and metastasis of breast carcinoma. Overexpression of cathepsin D is associated with poor clinical outcome and biologic aggressiveness of the breast cancer. We underwent immunocytochemical assay(ICA) for cathepsin D in fine needle aspiration cytology(FNAC) specimens from the breast carcinoma and benign breast diseases. In FNAC specimens cathepsin D was expressed in 21(42.9%) out of 49 cases of invasive ductal carcinoma, whereas negative result was observed in all 15 cases of benign breast diseases including 7 fibroadenomas, 6 fibrocystic diseases, and 2 benign ductal hyperplasias. Among the 11 FNAC specimens from ductal carcinoma in situ(DCIS), cathepsin D was expressed in 3 cases(27.3%). In FNAC specimens immunocytochemistry for cathepsin D showed positive result in 24 out of 60 carcinomas(sensitivity, 40%) and negative result in 15 out of all 15 benign breast diseases(specificity, 100%). No significant correlation was noted between cathepsin D expression in FNAC specimen and clinicohistological characteristics of the breast carcinoma, such as hormone receptors and cell differentiation. In conclusion, ICA of cathepsin D in FNAC specimens thought to be a good adjunct to differentiate malignancy from benign breast diseases.

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Residual Disease Following Conization of Women with Stage IA-IB1 Cervical Carcinoma in a High Incidence Region

  • Chatchotikawong, Usanee;Ruengkhachorn, Irene;Leelaphatanadit, Chairat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7383-7387
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    • 2014
  • Background: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. Materials and Methods: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. Results: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma.Conclusions: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.

Factors Predicting Microinvasion in Ductal Carcinoma in situ

  • Ozkan-Gurdal, Sibel;Cabioglu, Neslihan;Ozcinar, Beyza;Muslumanoglu, Mahmut;Ozmen, Vahit;Kecer, Mustafa;Yavuz, Ekrem;Igci, Abdullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.55-60
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    • 2014
  • Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

SQUAMOUS CELL CARCINOMA ARISING FROM RESIDUAL ODONTOGENIC CYST;Report of a Case & Review of Literatures (치성낭종으로부터 유래된 편평상피세포암종)

  • Kim, Yong-Kack;Park, Hyung-Kook;Kwon, Hyuk-Jin;Hyun, Jae-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.209-214
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    • 1997
  • Odontogenic cysts are relatively common pathologic lesions found in the oral and perioral structures, but the case of squamous cell carcinoma arising from those cysts are very uncommon. After first reported of that case in 1889 by Herman, Schwimmer collected 56 cases of previously reported squamous cell carcinoma arising in residual odontogenic cyst during about past one century. More than 60% of cases of carcinoma developing in odontogenic cysts arising in inflammatory periapical or residual cyst, and these tumors are usually well-differentiated with relatively good prognosis, and often are diagnosed as benign lesion in radiographic or clinical examination, therefore definitive diagnosis must be made by histologic examintation. We report a case and review the literatures, in our case, 78-year old woman were clinically and radiographically diagnosed as residual odontogenic cyst. But in histologic examination after enucleation of lesion, mass of squamous cell carinoma were observed, but in other area, typical cyst wall and lining epithelium were observed. And in some area, carcinoma in situ and invading squamous cell carcinoma into the lining epithelium were also observed.

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Surgical Treatment of Plummer - Vinson Syndrome with Carcinoma in Situ - One case report - (상피내암종으로 발전한 Plummer - Vinson 증후군의 수술적 치험 - 1례 -)

  • 최주원;장운하;박찬필;오태윤
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.495-499
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    • 2002
  • Plummer-Vinson syndrome(Paterson-Kelly syndrome) is characterized by dysphagia due to upper esophageal or hypopharyngeal web, iron deficiency anemia, and atropic oral and glossal mucosa. This syndrome is usually known as precancerous lesion that develops into postcricoid carcinoma. Universally, the clinical manifestations of this syndrome were markedly improved after oral iron replacement therapy or endoscopic balloon or electrocautery treatment. 63 year-old woman was received a short segment, free jejunal transfer to be released from esophageal stricture. After the operation, the stenotic lesion proved to be Plummer-vinson syndrome with carcinoma in situ by pathologic study.

Ultrasound Breast Elastographic Evaluation of Mass-Forming Ductal Carcinoma-in-situ with Histological Correlation - New Findings for a Toothpaste Sign

  • Leong, Lester Chee Hao;Sim, Llewellyn Shao-Jen;Jara-Lazaro, Ana Richelia;Tan, Puay Hoon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2673-2678
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    • 2016
  • Background: It is unclear as to whether the size ratio elastographic technique is useful for assessing ultrasound-detected ductal carcinoma-in-situ (DCIS) masses since they commonly lack a significant desmoplastic reaction. The objectives of this study were to determine the accuracy of this elastographic technique in DCIS and examine if there was any histopathological correlation with the grey-scale strain patterns. Materials and Methods: Female patients referred to the radiology department for image-guided breast biopsy were prospectively evaluated by ultrasound elastography prior to biopsy. Histological diagnosis was the gold standard. An elastographic size ratio of more than 1.1 was considered malignant. Elastographic strain patterns were assessed for correlation with the DCIS histological architectural patterns and nuclear grade. Results: There were 30 DCIS cases. Elastographic sensitivity for detection of malignancy was 86.7% (26/30). 10/30 (33.3%) DCIS masses demonstrated predominantly white elastographic strain patterns while 20/30 (66.7%) were predominantly black. There were 3 (10.0%) DCIS masses that showed had a co-existent bull's-eye sign and 7 (23.3%) other masses had a co-existent toothpaste sign, a strain pattern that has never been reported in the literature. Four out of 4/5 comedo DCIS showed a predominantly white strain pattern (p=0.031) while 6/7 cases with the toothpaste sign were papillary DCIS (p=0.031). There was no relationship between the strain pattern and the DCIS nuclear grade. Conclusions: The size ratio elastographic technique was found to be very sensitive for ultrasound-detected DCIS masses. While the elastographic grey-scale strain pattern should not be used for diagnostic purposes, it correlated well with the DCIS architecture.

Treatment Outcome and Analysis of the Prognostic Factors of Ductal Carcinoma in situ Treated with Breast Conserving Surgery and Radiotherapy (유방 관상피내암의 유방 보존술 후 방사선 치료의 성적과 예후 인자 분석)

  • Kim, Kyoung-Ju;Huh, Seung-Jae;Park, Won;Yang, Jeong-Hyeon;Nam, Seog-Jin;Kim, Jeong-Han;Lee, Sung-Kong;Lee, Jee-Hyun;Kang, Sung-Soo;Lee, Jeong-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.11-16
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    • 2004
  • Purpose: To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy Materials and Methods: From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses ($10\~14$ Gy) administered to the primary tumor bed in some patients with close ($\leq$2 mm) or positive resection margin. The median follow-up period was 43 months (range $10\~102$ months). Results: The 5-year local relapse free survival and overall survival rates were 91 and $100\%$ respectively. Local relapse occurred in 6 patients ($6.3\%$). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0). Conclusions: The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.